Attitudes towards models of abortion care in sexual and reproductive health: perspectives of Australian health professionals.

Abstract

Background Abortion care is typically undertaken by doctors; however, alternate models, including nurse-led care, are increasingly seen as viable alternatives. However, attitudes towards the leadership of alternate models can be a barrier to change. We explored the acceptability of different models of abortion care, and whether attitudes differed by health profession for those working in sexual and reproductive health. Methods Our mixed method survey explored how doctors, nurses/midwives and those working in administrative roles in primary care in Australia felt about three models of abortion care: doctor-led, nurse-led and self-administered. ANOVAs compared favourability ratings and attitude strength across groups, and qualitative data exploring how they felt about each model was thematically analysed using Leximancer. Results Attitudes towards doctor-led and nurse-led models of care were overwhelmingly positive. However, doctors perceived doctor-led care more favourably than other professionals, and felt it provides a more holistic, safer experience, that opportunistically facilitated discussions about other sexual and reproductive health matters. Self-administered care was perceived unfavourably by ~60% of participants, and was associated with significant safety concerns. Conclusions Most health professionals working in sexual and reproductive health care perceive that nurse-led models of care are viable and acceptable, although doctors feel there are additional benefits to the current model. Self-administered abortion is overwhelmingly perceived as unsafe. Nurse-led care models could increase access to safe abortion in Australia, and are perceived favourably by those working in sexual and reproductive health care.